Joe Biden’s Health and Prostate Cancer: Was It Discovered During His Presidency?

Introduction

President Biden’s health has been a subject of intense scrutiny. Official medical releases during 2023–2024 largely portrayed him as “fit for duty,” with routine annual physicals (Nov 2021, Feb 2023, Feb 2024) certified by White House physician Kevin O’Connor as showing “no new concerns” and affirming he was a “healthy, vigorous 78-year-old [later 81-year-old] male” In practice, O’Connor was physically very close to the President: he greets Biden every morning, travels in close proximity (even sharing a room on trips), and maintains an office adjacent to the Oval Office. Karine Jean-Pierre has said Biden gets verbal doctor “check-ins” twice weekly while exercising, reflecting the high-touch Presidential Medical Unit (PMU) system.

By law there is no formal requirement to publicly disclose presidential health details beyond voluntary summaries, and confidentiality is closely guarded. Historically, administrations have often tightly controlled medical information (FDR’s polio, Reagan’s Alzheimer’s after leaving office, etc.). Experts note the inherent conflict of interest for a presidential physician (a political appointee) in disclosing problems. For example, Dr. Kevin O’Connor is a longtime Biden family friend and associate (having treated family members and even introduced Biden’s brother to lucrative VA contracts). Observers like Bert Park (a Democratic official and son of Eisenhower’s surgeon) warn that one “can’t depend on the presidential physician to come clean” if problems arise. Critics have described a “conspiracy of silence” around Biden’s health, noting his historically few press conferences and the Biden team’s efforts to push back on reporting about his age or cognition. In July 2024, for instance, when the NYT reported a Parkinson’s specialist had visited the White House frequently, the White House quickly issued an O’Connor memo denying any Parkinson’s treatment and insisting those visits were for other staff.

Medical Releases (2023–2024) and Screening Practices

The White House released only a few substantive medical bulletins in 2023–24. Notable public disclosures included:

• March 3, 2023: O’Connor reported a routine annual physical had found a skin lesion on Biden’s chest, biopsy-confirmed as basal-cell carcinoma (a low-risk skin cancer). The lesion was “successfully removed” and needed no further treatment.
• Feb 2024: After the 2024 exam, O’Connor’s memo again found “no new concerns”, adding only a diagnosis of sleep apnea (undisclosed in earlier reports) and minor issues like acid reflux and degenerative spine changes. The report noted a stiff gait (chronic) and peripheral neuropathy, attributing them to arthritis and past injuries. Crucially, no mention of any prostate exam or PSA test appeared in any summary. White House doctors similarly omitted cognitive testing from these releases: press memos and transcripts confirm neither the 2021, 2023 nor 2024 exams included formal cognitive tests, and Jean-Pierre even claimed Biden “passes a cognitive test every day” via his duties.

No official report ever mentions a prostate-specific antigen (PSA) test or digital rectal exam (DRE). In fact, at age 80–81 Biden was above the age at which routine prostate screening is advised. The U.S. Preventive Services Task Force explicitly recommends against PSA-based screening in men over 70. Thus the omission of PSA/DRE is consistent with standard practice and White House precedent. However, Biden’s subsequent diagnosis raises questions: on May 18, 2025, his office announced he has Gleason-9 prostate cancer with bone metastases – a far more advanced state than the “localized” cancer publicly reported in 2023. This abrupt change suggests either a rapid progression or previously unreported disease.

Symptoms and Behavioral Signs

Publicly visible symptoms during Biden’s presidency may offer clues. He is known to have some orthopedic and neurological issues: the annual exam memos note gait stiffness and early-morning worsening that improves throughout the day. Jean-Pierre acknowledged that the PMU is right next door to the residence, and Biden often did exercise rounds with verbal check-ins, which might mask brief episodes of fatigue or disorientation inside. However, independent accounts do report unease: veteran Democrats and aides told the press Biden sometimes had “moments later in the evening when his thoughts seem jumbled..” After the June 27, 2024 debate, Biden appeared “far worse” than usual, with “trails off mid-sentence” and confusion, raising alarms. Members of Congress (e.g. Reps. Mike Quigley and Dean Phillips) later described noticing Biden looking “sapped” and having reduced “walking skills” and coherence even in 2023 trips.

However, none of these public signs are specific to prostate cancer. Early prostate cancer is often silent; advanced disease can cause fatigue, weight loss, bone pain or urinary symptoms. Notably, Biden’s office statement in 2025 cited “increasing urinary symptoms” as the trigger for his check-up. This suggests lower-urinary-tract irritation, a common sign of prostate problems. Sleep apnea (diagnosed 2023) could also cause daytime tiredness, which might have amplified any fatigue. But there is no record of persistent bone pain or other metastatic symptoms during his presidency, nor any abrupt change on public appearances that can be directly traced to cancer. The “good 5–6 hour window” notion (that Biden only functions well for part of the day) appears in partisan commentary, but is unverified. In short, public behavior fits both advanced age and known conditions (sleep apnea, arthritis, neuropathy) as explanations.

Evidence of Concealment or Awareness

Media excerpts from Jake Tapper’s forthcoming Original Sin allege that Biden’s inner circle zealously protected him from scrutiny. CNN/Axios reported aides discussed using a wheelchair for him, though not publicly. The New Yorker excerpt claimed he once failed to recognize a friend (actor George Clooney) at an event. None of these claims are independently verified: the White House has declined to fact-check the book, saying its authors “did not fact check the book with us.” In context, press behavior during Biden’s term was unusually deferential: one Guardian analysis notes fewer press conferences than any president since Reagan, and criticism of his age was heavily discouraged.

What about the cancer itself? On May 13, 2025 after Biden left office, news broke that a “small nodule” was found in his prostate during a routine check-up. He then underwent evaluation and was diagnosed with Gleason-9 metastasized disease. This creates a stark contrast: during his presidency, the White House had characterized his 2023 diagnosis as localized, low-risk cancer treatable with minor surgery. Now, it is an aggressive, hormone-sensitive cancer already in his bones. There is no public explanation yet for this discrepancy. Medically, Gleason-9 cancer typically progresses over several years; several studies report that even with definitive treatment many such patients develop metastases within 5 years. If Biden’s cancer was truly that aggressive all along, it would be unusual (though not impossible) that it wasn’t known or had not metastasized until now.

📚 Related: Multiple White House aides reportedly warned of Biden’s limited windows of coherence and internal health concerns. These accounts are explored inJake Tapper’s Original Sin, based on sourced interviews and leaked internal memos.

Incentives and Capacity for Suppression

The White House and Democratic Party had powerful motives to downplay any serious illness. Biden’s age was already seen as a campaign vulnerability: by mid-2024, even Democrats fretted that voters viewed him as frail or forgetful. Admitting a metastatic cancer diagnosis during the campaign would likely have prompted demands for an immediate withdrawal or special elections. In contrast, portraying a minor cancer as “effectively treated” minimized concern. The DNC has broad control over internal messaging and access to Biden. The President’s own doctor answers only to the President, and the PMU operates in near-secrecy behind White House gates. As Politico noted, O’Connor works for “the guy you’re examining”, creating a structural disincentive to raise red flags publicly.

That said, any active suppression would require complicity by many: Dr. O’Connor, senior aides, and possibly family members. There is no concrete evidence (documents or whistleblowers) that such a conspiracy existed. Nor were there clear leaks suggesting a known, worse diagnosis hidden from the public. The change from the 2023 announcement (early, localized cancer) to the 2025 reality (advanced, metastatic) is suspicious, but it could also reflect genuine biological progression that only became apparent late. In sum, while the incentive and means to hide a serious condition clearly existed, proving deliberate suppression is speculative at this time.

Likelihood Assessment

We rate the two central claims on a 0–100% plausibility scale, based on available evidence:

• Suppressed Known Diagnosis: Likelihood ~15–25%. This hypothesis would require that Mr. Biden’s metastatic cancer was effectively known to his doctors or aides during his presidency and intentionally kept secret. The main support for this is circumstantial: the discrepancy between the 2023 and 2025 statements, plus anecdotal claims of a “cover-up.” However, there is no smoking-gun proof. All official physicals declared him fit, and no credible source reported seeing scans or lab results withheld from the public. The White House did come clean quickly on unrelated issues (e.g. Parkinson’s rumors, sleep apnea discovery), which suggests transparency on health matters when pressured. In absence of corroborating leaks or documents, deliberate suppression seems unlikely.
• Undiagnosed But Developing Condition Impacting Behavior: Likelihood ~35–50%. In this scenario, Biden’s cancer (or its early metastasis) was simply not detected while he was in office, yet it was biologically progressing and contributing to fatigue or other symptoms. This is partly plausible because older men often do not get annual prostate screening, and early symptoms can be subtle. If his cancer began in 2022 or early 2023, it could have advanced over the ensuing 2–3 years without overt detection – especially if no PSA was done. However, high-grade prostate cancer often causes some PSA rise or urinary problems years before overt metastasis. The Biden Press Office did report “increasing urinary symptoms” only in May 2025, not earlier. Moreover, prostate metastases rarely produce cognitive symptoms directly. Thus, while undiagnosed disease could plausibly explain some physical decline or fatigue, attributing his well-documented cognitive lapses to it is tenuous. Overall, it’s moderately plausible Biden’s cancer simply escaped detection until after leaving office, but unlikely to be the primary cause of his behavioral variability.

Facts Classification (Red/Gray/Blue)

• Red (Confirmed): These points are documented in credible sources or official records. For example: O’Connor’s memos (White House) explicitly report no neurologic issues and the conditions listed above; Biden’s 2025 diagnosis (Gleason 9, metastasis) is confirmed by his own office and major media. Published medical guidelines (e.g. USPSTF) advise against PSA screening past age 70. These are hard facts.
• Gray (Inferred): These points are reasonable interpretations or very likely inferences. For instance: White House staff had motive to suppress bad news (implied by Democratic concerns about age) and the President’s doctor has great discretion (implied by physician’s role); Biden’s fatigue could partly come from untreated cancer or sleep apnea. We infer from sources that aides built a “protective” inner circle. The timeline linking Biden’s decline to cancer biology is also inference-based: Gleason-9 cancers often metastasize over ~2–5 years, which suggests Biden’s tumors could have started before 2025. These points blend fact with medical logic.
• Blue (Speculative): These are allegations or rumors with minimal verification. For example: That Biden’s team deliberately lied about his cancer or that his good-performance window is exactly 5–6 hours each day. The sensational excerpts from Original Sin (wheelchair discussion, not recognizing Clooney) are also unverified claims at present. By definition, these remain conjectural until independently confirmed.

For a more detailed narrative account of the Biden White House’s internal handling of these health concerns, Tapper and Axios’ Alex Thompson outline it in Original Sin—a timely book that, despite lacking official sourcing, forces the medical-political secrecy debate into the open.

Conclusion: Operational Silence or Medical Drift?

The available evidence supports a moderate probability that Joe Biden’s advanced prostate cancer was biologically developing during his presidency—possibly as early as 2022—but remained either undetected or strategically untested due to his age, existing White House medical protocols, and political incentives. The Gleason 9 metastatic diagnosis in 2025 almost certainly implies a multi-year progression, which raises serious doubts about the White House’s failure to publicly acknowledge its possibility in prior years.

However, there is no definitive proof that a formal diagnosis was made and actively suppressed during his time in office. The physician’s proximity, combined with the complete absence of PSA testing and the administration’s track record of downplaying age-related concerns, fuels strong circumstantial suspicion—but not hard confirmation.

Biden’s visible limitations—short workdays, sporadic confusion, protective press scheduling—can be explained through a convergence of factors, including advanced age, sleep apnea, chronic pain, and possibly undetected early-stage cancer. His inner circle’s tight control over information flows, lack of cognitive testing, and selective transparency compound the opacity.

Bottom line:
While the case for a “diagnosed and concealed” cancer rests on circumstantial indicators, the failure to pursue or disclose appropriate screening in a high-risk patient—with daily physician access—may represent a form of passive suppression. The structure of presidential medicine allowed this, and the political stakes made it advantageous.

Further investigation is warranted into:

• The role of Dr. Kevin O’Connor and the Presidential Medical Unit;
• The 2023 prostate procedure (was it truly curative?);
• The communication between medical staff and political handlers;
• And whether institutional norms at the highest level now treat informational ambiguity as a feature, not a flaw.

Annex: Timeline of Biden’s Health vs Cancer Progression

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